Work with parents to spread the good word about pediatric nutrition
By Cathy Hester Seckman, RDH
Children and teens have been under heavy fire for years on the nutritional front. Advertisers target them directly: "Do the Dew!" "Elevate your game." "No one can eat just one!" "Pizza, pizza!" "Once you pop, you can't stop!" "Go stronger for longer." "I'm lovin' it!"
With all that urgency, combined with kids' natural tendency to eat only sweet, salty, familiar food, is it any wonder they want to live on fast food, sports drinks, and soda?
The Centers for Disease Control reports that most American children don't have a healthy diet. According to the CDC, most U.S. youth:
- Do not meet the daily recommendations for fruits, vegetables, or whole grains
- Consume more sodium than necessary
- Get 40% of their calories from soda, fruit drinks, dairy desserts, grain desserts, pizza, and whole milk1
- Drink more regular soda than milk
It's easy to see that a diet made up of 40% sugar, acids, and fermentable carbohydrates would play havoc with developing teeth.
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Schools have been blamed for the poor diets of students, but according to the School Health Policies and Programs Study (SHPPS), progress is being made. Between 2000 and 2012, these figures represent increased percentages of schools that prohibit junk foods to students in different settings:
- A la carte during breakfast and lunch, 23.1% to 41.7%
- At concession stands, 1.4% to 5.8%
- In after-school or extended day programs, 7.3% to 21.4%
- In school stores, canteens, or snack bars, 3.9% to 28.3%
- In vending machines, 4.1% to 43.4%
Between 2000 and 2012, these are the percentage changes for school food preparation practices:
- Using low-fat or nonfat yogurt, mayonnaise, or sour cream, 26.8% to 53.1%
- Reducing the amount of fats and oils in recipes or using low-fat recipes, 25.3% to 41.4%
- Skimming fat from broth, soup, stew, or gravy, 60.2% to 70.9%
- Steaming or baking vegetables, 59.5% to 83.7%
The frightening increases in childhood obesity and Type II diabetes, along with more diagnoses of food allergies and sensitivities, have largely fueled these improvements in school breakfasts and lunches. More than half of districts, for instance, require schools to have a written plan for feeding students with severe food allergies.3
Dental caries, however, remains "the most prevalent chronic disease in … children" according to the National Institute of Dental and Craniofacial Research.4 The National Health and Nutrition Examination Survey (NHANES) tells us that although the incidence of caries in primary teeth declined between the 1970s and 1990s, it has since increased. Almost half of American children ages 2 through 11, 42%, have had caries in their primary teeth; 21% of children age 6-11, almost a quarter, have had dental caries in their permanent teeth.5
Children's diets, of course, have much to do with this. As hygienists on the front lines, seeing acid erosion from sports drinks or early childhood caries caused by endless snack foods, we face an uphill battle.
Here are some tips for talking to parents about nutrition. Suppose, for instance, little Brayden's favorite breakfast cereal is full of sugar. If he comes in with four new cavities, the cereal, among other things, should be replaced by healthier choices. Mom doesn't have to be mean about it, though. We've all heard frustrated parents cry, "That's it! No more sugar for you! You can kiss all that cereal and candy and soda goodbye! Forever!"
Give Mom this idea as an alternative. Sometime when Brayden's not watching, replace 10 fruity cereal pieces with 10 Cheerios, a lower-sugar alternative that looks very similar. A few days later, replace 25 fruity pieces with 25 Cheerios in each bowlful. Keep going until the cereal bowl is filled with mostly Cheerios, and a few fruity pieces thrown in for color. This still isn't a perfect breakfast, but it's a lot better than it was.
If Brayden also loves apple juice and refuses all other drinks, Mom can cut the juice with water -- an eighth of a cup on the first day, a quarter cup a few days later, and so on, until Brayden is meeting the nutritional guideline of no more than 4 to 6 ounces of juice daily. If Brayden should decide he doesn't like apple juice anymore, Mom can suggest alternatives that are kinder to his teeth.
Tell Mom she can blame you for a menu change. "Brayden, remember when we went to see the hygienist at the dentist's office last week? You had four cavities, and we don't want that to happen again, do we? Your hygienist says that you can still have your snacks every day, but some of them need to be more healthy, so your teeth can be more healthy. For our morning snack today, instead of cookies, let's have either grapes or string cheese; you can choose." If Brayden doesn't want grapes or cheese, then he must not be very hungry. Every week or so, another snack can become a healthy one.
Teach Mom about fermentable carbohydrates and acid challenges. It's better for Brayden to eat three cookies all at once than to nibble at one cookie for an hour. It's better for him to down a full bottle of soda in five minutes than to sip continuously at half a bottle for the length of an average TV cartoon.
Remind Mom that plain yogurt with raw fruit added is better than children's yogurt with added sugar and fruit flavoring; nuts, seeds, and popcorn are better than snack cakes; and chocolate, which has been shown to have anti-cariogenic properties, is better than sticky, gummy, sugary candy.
Be sure Mom knows that according to the American Academy of Pediatrics, sports and energy drinks are not appropriate for children.6
Sometimes you can talk until you're blue in the face, and your recommendations won't make a dent in a family's nutritional habits. Sometimes, though, what you say can spark an idea in a parent's mind, or get a teen to question their food choices, and those are the times that make us keep trying.
CATHY HESTER SECKMAN, RDH, is a frequent contributor based in Calcutta, Ohio. Besides working in a pediatric dental practice, Seckman is a prolific freelance writer, a book indexer, and a speaker on dental and writing/indexing topics. She can be reached at firstname.lastname@example.org.
2, 3. http://www.cdc.gov/healthyyouth/shpps/2012/pdf/shpps-results_2012.pdf">http://www.cdc.gov/healthyyouth/shpps/2012/pdf/shpps-results_2012.pdf
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